No abstract

Objective:To evaluate the effects of the 1977 and 1995 tobacco sales bans on tobacco acquisition of minors.Design:Biennial nationwide postal surveys (adolescent health and lifestyle survey, AHLS) in 1977–2003; annual classroom surveys (school health promotion survey, SHPS) in 1996–2003.Setting and participants:Entire Finland—12, 14, 16, and 18 year olds (AHLS, n  =  80 282); eighth and ninth graders (14–16 year olds) (SHPS, n  =  226 681).Main outcome measures:Purchase of tobacco from commercial sources during the past month, purchase from different commercial (shop, kiosk, other outlet) and social sources, ease of buying tobacco, overall acquisition of tobacco products, daily smoking, tobacco experimenting.Results:Decrease in tobacco purchase from commercial sources was small and short term after 1977 but large and permanent after 1995: purchase rate among 14 year old smokers diminished from 90% to 67% in 2003, 16 year olds from 94% to 62%. Purchases in shops decreased most (14 year olds: from 39% to 14%; 16 year olds: from 76% to 27%); purchases in kiosks less. An increase was observed in obtaining tobacco from other outlets and friends (social sources). Only 2–3% of 14–16 year old smokers used commercial sources exclusively when obtaining tobacco. Daily smoking began to decrease after 2001, following an earlier decrease in those experimenting. No changes were observed among age groups not targeted by the ban.Conclusions:Legislation appears to have permanently changed tobacco sales practices and decreased purchases from commercial sources. Social sources need to be taken into account when controlling access to tobacco. Sales bans should be accompanied by other health promotion measures.

Home smoking bans will contribute towards a reduced risk of child smoking even when parents smoke. Tobacco control legislation needs to be enhanced with measures promoting awareness of the benefits achievable through strict home smoking bans. Families characterized by lower socioeconomic status and smoking parents are particular target groups.

The total sales ban did not stop snus use; instead, the increase continued after the ban. Friends who travel to neighbouring countries act as go-betweens reselling snus. Snus is used even by the youngest adolescents, thus contributing to the nicotine dependence process.